Technical Factors Contributing to Nonunion in Supracondylar Distal Femur Fractures Treated With Lateral Locked Plating: A Risk-Stratified Analysis.

Objective: To identify technical factors associated with nonunion after operative treatment with lateral locked plating.

Design: Retrospective cohort study.

Setting: Ten Level I trauma centers.

Risk Factors for Reoperation to Promote Union in 1111 Distal Femur Fractures.

Objectives: To identify modifiable and nonmodifiable risk factors for reoperation to promote union after distal femur fracture.

Design: Multicenter retrospective cohort study.

Setting: Ten Level-I trauma centers.

Predictors of Deep Infection After Distal Femur Fracture: A Multicenter Study.

Objectives: To identify potentially modifiable risk factors for deep surgical site infection after distal femur fracture.

Design: Multicenter retrospective cohort study.

Setting: Ten Level-I trauma centers.

Tranexamic acid use decreases transfusion rate in children with cerebral palsy undergoing proximal femoral varus derotational osteotomy.

Previous studies demonstrated the safety of tranexamic acid (TXA) use in cerebral palsy (CP) patients undergoing proximal femoral varus derotational osteotomy (VDRO), but were underpowered to determine if TXA alters transfusion rates or estimated blood loss (EBL). The purpose of this study was to investigate if intraoperative TXA administration alters transfusion rates or EBL in patients with CP undergoing VDRO surgery.We conducted a retrospective review of 390 patients with CP who underwent VDRO surgery between January 2004 and August 2019 at a single institution.

Distal Humerus Traction Radiographs: Is the Interobserver and Intraobserver Reliability Comparable With Computed Tomography?

Objectives: To compare the interobserver and intraobserver reliability of traction radiographs with 2-dimensional computed tomography (2D CT) in distal humerus fracture classification and characterization.

Design: Randomized controlled radiographic review of retrospectively collected data.

Setting: Academic Level 1 trauma center.

Correlating Arthroscopic and Radiographic Findings of Deep Deltoid Ligament Injuries in Rotational Ankle Fractures.

Background: The deep deltoid ligament (DDL) is a key stabilizer to the medial ankle and ankle mortise and can be disrupted in ligamentous supination external rotation type IV (LSER4) ankle fractures. The purpose of this study was to define the medial clear space (MCS) measurement on injury mortise radiographs that corresponds with complete DDL injury.

Methods: A retrospective record review at a level 1 hospital was performed identifying patients with LSER4 ankle fractures who underwent arthroscopy and open reduction internal fixation.

Functional Outcomes of Patella Fractures Treated With Anterior Plate Osteosynthesis at One Year.

Objectives: To evaluate the functional outcomes of patients with displaced patellar fractures treated with anterior plate constructs.

Design: Prospective cohort and retrospective clinical and radiographic assessment.

Setting: Level I Trauma Center.

External Fixator-Assisted Reduction of Distal Femur Fractures: A Technical Trick.

Restoration of anatomical alignment while preserving the soft-tissue envelope around the fracture site remains a challenge during distal femur fracture fixation. Although the lateral distal femoral locking plate allows surgeons to achieve adequate bony stability, their application has been associated with malalignment leading to inferior outcomes. We propose a biologically friendly, percutaneous technique that sequentially reduces and aligns distal femur fractures with an anterior external fixator before definitive fixation with a lateral distal femoral locking plate.

Current illicit drug use profile of orthopaedic trauma patients and its effect on hospital length of stay.

Introduction: The purpose of this study was to investigate the prevalence of illicit drug use among patients admitted with traumatic orthopaedic injuries and to determine its effect on hospital length of stay (LOS). We hypothesized that patients with pre-injury drug use would have a longer hospital LOS compared to those who do not use drugs.

Methods: We conducted a retrospective cohort study at our level 1 urban trauma center of patients admitted with traumatic orthopaedic injuries between 2013 and 2015 with urine toxicology screening.

Biomechanical comparison of fixation stability using a Lisfranc plate versus transarticular screws.

Background: To obtain adequate fixation in treating Lisfranc soft tissue injuries, the joint is commonly stabilized using multiple transarticular screws; however iatrogenic injury is a concern. Alternatively, two parallel, longitudinally placed plates, can be used to stabilize the 1st and 2nd tarsometatarsal joints; however this may not provide adequate stability along the Lisfranc ligament. Several biomechanical studies have compared earlier methods of fixation using plates to the standard transarticular screw fixation method, highlighting the potential issue of transverse stability using plates.

A Medial Malleolar "Fleck Sign" May Predict Ankle Instability in Ligamentous Supination External Rotation Ankle Fractures.

Background: Ankle joint stability dictates treatment in ligamentous supination external rotation ankle injuries (LSERAI). Investigation of the medial structures that support the ankle mortise is critical, and a small avulsion fracture, or "fleck", of the medial malleolus is occasionally encountered. This study aimed to assess the utility of this medial malleolus fleck sign (MMFS) in diagnosing instability requiring surgery in LSERAI.

Low-Cost Intra-Articular Distraction Technique Using Kirschner Wires and a Toothed Lamina Spreader.

We describe a low-cost (instrument cost) technique for joint distraction using 2 Kirschner wires and a toothed lamina spreader in lieu of a Hintermann distractor. The described technique allows for temporary intra-articular distraction and visualization and preservation of the articular surface with extra-articular instrumentation. The technique can also allow for closed reduction and percutaneous treatment in cases of soft tissue compromise.

Case Series Using a Novel Implant and Accelerated Rehabilitation for Patients Undergoing an Isolated Talonavicular Arthrodesis.

Unlabelled: Talonavicular (TN) arthrodeses for TN arthritis have a high rate of nonunions for an essential hindfoot joint. In this case series, 12 patients underwent an isolated TN arthrodesis using a novel implant (IO FiX) by a single surgeon with a minimum 1-year follow-up (30.1 ± 14.

Traumatic anterior instability of the pediatric shoulder: a comparison of arthroscopic and open bankart repairs.

Background: Arthroscopic and open Bankart repairs have proven efficacy in adults with recurrent anterior shoulder instability. Although studies have included children in their analysis, none have previously compared functional outcomes or redislocation rates between these 2 methodologies for anteroinferior glenoid labrum repair in this young population. We hypothesize that open and arthroscopic Bankart repair in children will have similar functional outcomes and redislocation rates, but differing results from adults treated in a similar manner.

Body posture and backpack loading: an upright magnetic resonance imaging study of the adult lumbar spine.

Purpose: Axial loading of the spine while supine, simulating upright posture, decreases intervertebral disc (IVD) height and lumbar length and increases lumbar lordosis. The purpose of this study is to measure the adult lumbar spine's response to upright posture and a backpack load using upright magnetic resonance imaging (MRI). We hypothesize that higher spinal loads, while upright and with a backpack, will compress lumbar length and IVD height as well as decrease lumbar lordosis.

Altered disc compression in children with idiopathic low back pain: an upright magnetic resonance imaging backpack study.

Study Design: This study is a repeated measures design to measure the lumbar spine's response to common backpack loads in children with idiopathic low back pain (ILBP) using upright magnetic resonance imaging (MRI).

Objective: The purpose of this study is to analyze the lumbar spine's response to backpack loads with upright MRI in children with ILBP to compare their results with previously published normal child data under the same conditions. We hypothesize that typical backpack loads will have a different effect on the lumbar spine of normal children and children with ILBP.